Rehabilitative Ultrasound Imaging

The physiotherapists at KSSP have been utilising ultrasound to aid in the specificity of diagnosis and rehabilitation for the past 7 years. The focus of this use has been on rehabilitating correct core muscle function. Given the improved patient outcomes this has provided its use has been extended into shoulder and hip rehabilitation, women’s health and as an adjunct in our assessment of muscle and ligament injuries.

Core Stability

KSSP focus on rehabilitative core stability training. Rehabilitative because we work with clients who have weak core muscles or those who are unable to elicit a contraction, as typically is the case for persons with chronic and recurring pain.

The genesis of poor core is undoubtedly different for each person, however despite these differences there are some common ‘themes’. In the background of these themes one has to remember:

that the body is a wonderful ‘cheat’ – it will adapt to find a way for you to perform a movement or activity.

that the body is essentailly lazy – it will find the least energy expending way to perform a task

that movement patterns are a result of repetition, of learned muscle responses, similar in concept to our development of habits (good or bad) in other areas of our lives.

With these themes in mind, we often see similar repetition of the body’s compensation patterns in patients. The common areas seen are:

atrophied and fibrous, fatty deep multifidus muscles

over-activity in the oblique muscles

poor diaphragmatic involvement in breathing

a depression of the pelvic floor muscles where elevation should be occurring

Sadly, patients who have undertaken core work in the past have often done exercises that have reinforced at least one deliterious compensation pattern and have therefore not been able to progress to the development of automatic core stability – where the body subconsciously correctly performs core muscle function.

The KSSP approach analyses your current core patterns with the aid of the ultrasound and both the patient and therapist can easily see the incorrect patterns. Exercises to overcome the poor patterns and any identified muscle mis-timing are then commenced. Generally progress is rapid, with evidence of change from week to week. Treatments are therefore undertaken weekly and historically 6-8 treatments are required to progress to a stage of independant exercise.

The programme aims to help you improve in 3 areas:

core stability

joint mobility

flexibility of your spinal structures

For the core stability area, there are further 3 sub-areas of focus:

Timing – research now shows that in the case of low back pain, contraction of the core muscles occurs with a short delay after a movement, instead of the desired pre-emptive nature

endurance -ultimately your core muscles must provide you with the necessary support throughout the whole day

strength – this is the area most people incorrectly focus. Without correct timing you will only strengthen and reinforce the poor patterns.